Measuring the care risk in older adults with dementia: a scoping review

Older adults with dementia face heightened care risk, defined as the uncertainty surrounding adverse events arising from the complex interplay of factors related to the individual, caregivers, the physical/social environment, and care processes during daily, rehabilitative, or recreational activities. It poses significant threats to their well-being, that of their families, and society at large. However, the approach to assessing care risk in older adults with dementia remains unclear. We aimed to identify current risk assessment tools and perspectives for older adults with dementia by providing a comprehensive overview and highlighting significant gaps in the current research.

This study adhered to the Joanna Briggs Institute methodology for scoping review alongside the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Eight databases, including PubMed, CINAHL, Web of Science, Cochrane Library, SinoMed, CNKI, WANFAGN, and WIP, were searched from their inception to 30th December 2023. We identified 13,106 articles, 16 of which met the inclusion criteria. The research approaches adopted in the reviewed articles were qualitative analysis (N = 4, 25%), quantitative analysis (N = 7, 43.75%), and mixed methods (N = 5, 31.25%). Five tools for measuring care risk were identified. Among them, the most common domains in older adults with dementia are the living environment, characteristics of older adults, caregivers, and social support.

Four primary care risk dimensions were identified: physical health, caregivers, social support, and environment, which inform risk assessment and training. Notably, existing tools require longitudinal studies to validate stability, and future research should prioritize patient-centered assessment perspectives.